Archived Information

U. S. Department of EducationOffice of Postsecondary Education

Washington, D.C. 20006-8524

Fiscal Year 2008 Application for the

COLLEGE ACCESS CHALLENGE GRANT PROGRAM (CACGP)

(CFDA NUMBER 84.378)

CLOSING DATE: June 27, 2008OMB Control Number: 1840-001

Expiration Date: 05/31/2011

COLLEGE ACCESS CHALLENGE GRANT PROGRAM (CACGP)

Table of Contents

Program Overview……………………………………………………………………………….3AuthorityOfficial Documents NoticePurposeEligibilityActivities and Services

Program Requirements………………………………………………………………………….4Qualifying Students and FamiliesSub-Grants to Non-ProfitsFederal Share and Non-Federal MatchingAnnual Performance Report

Program Statute……………………………………………………………………………….…6

Application Process……………………………………………..………………………………14InstructionsTitle PageSections I - VII

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COLLEGE ACCESS CHALLENGE GRANT PROGRAM(CACGP)

I. PROGRAM OVERVIEW

Legislative Authority:

Title VII, Part E of Higher Education Act of 1965, as amended, 20 U.S.C. Section 1141

Official Documents Notification:

The official document governing this application is available electronically at the following Web site: www.ed.gov/programs/cacg.

Purpose:

The College Access Challenge Grant Program (CACGP) is a formula grant program that is designed to foster partnerships among Federal, State and local government entities and philanthropic organizations to significantly increase the number of underrepresented students who enter and remain in postsecondary education. CACGP provides two-year grants to States to meet the needs of underrepresented students and families.

Eligibility:

The Governor of the State designates the State agency (i.e., a State agency with jurisdiction over higher education or another State agency) that is eligible to apply for a CACGP grant. Each State is eligible to receive one CACGP grant. In cases where a State fails to meet the matching requirement or fails to comply with other grant requirements, the Secretary shall reduce the amount of grant payment to the State proportionately and may award the proportionate reduction amount of the grant directly to a philanthropic organization.

Authorized Activities/Services:

1) Provide information to students and families on postsecondary education benefits, opportunities, planning and career preparation;

2) Provide information on financing options, including activities that promote financial literacy and debt management among students and families;

3) Conduct outreach activities for students who may be at risk of not enrolling in or completing college;

4) Assist students in completing the Free Application for Federal Student Aid (FAFSA);5) Offer need based grant aid to students;6) Implement professional development for guidance counselors at middle and secondary

schools, and financial aid administrators and college admissions counselors at institutions

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of higher education, to improve such individuals’ capacity to assist students and parents with:

a) Understanding: Entrance requirements for admission to institutions of higher education,

and State eligibility requirements for Academic Competitiveness Grants or

National SMART Grants;b) Applying to institutions of higher education, applying for financial assistance and

scholarships;c) Activities that increase students’ ability to successfully complete the coursework

required for a postsecondary degree (including tutoring and mentoring); and d) Activities to improve secondary school students’ preparedness for postsecondary

entrance examinations.7) Repayment of student loans, student loan cancellation, or lowering of interest rates.

States are not allowed to use funds to promote any lender’s loans.

II. PROGRAM REQUIREMENTS

Qualifying Students and Families:

States must make activities and services available to all qualifying students and families regardless of a) choice of postsecondary institution; b) type of student loan received; c) server of such loan; and d) student’s academic performance. Students and families cannot be charged a fee to participate in activities and services. In the case of an activity providing grant aid, States cannot require students to meet any condition other than eligibility for Federal financial assistance under Title IV of the Higher Education Act of 1965.

Priority: Priority must be given to students and families who are living below the poverty line applicable to the individual’s family size.

Sub-Grants to Non-Profit Organizations:

States may award sub-grants to one or more non-profit organizations, or partnerships of organizations, in the State to carry out the services and activities if the non-profit organization or partnership—

1. was in existence on or before September 27, 2007; and2. is participating in activities and services related to increasing access to higher

education.

Federal Share and Non-Federal Matching Requirement:

Federal funds may be used to pay for up to two thirds (2/3) of the cost of the activities and services provided as part of a College Access Challenge Grant. States are required to provide non-Federal funds equal to one third (1/3) of the costs of authorized activities and services. This non-Federal match may be met through cash or in-kind contributions and cannot be waived.

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Matching contributions may be provided from State resources, contributions from private organizations, or both.

Documentation of matching contributions must contain adequate source documentation for the claimed cost sharing, provide clear valuation of in-kind matching, and provide support of cost-sharing by grant partners. Grantees are required to value in-kind contributions in accordance with relevant Office of Management and Budget (OMB) circulars and the Education Department General Administrative Regulations (EDGAR). In most cases, grantees must value in-kind contributions of facilities and equipment using depreciation rather than fair market value.

If a State fails to provide the full non-Federal share required, the Secretary will reduce the amount of the grant payment proportionately, and may award the proportionate reduction amount of the grant directly to a philanthropic organization.

Annual Performance Report Requirement:

States are required to provide an annual performance report that outlines the activities and services that were implemented during the performance period, the associated cost of each activity or service, the number and percentage of students that participated in such activities and services, and the total non-Federal matching contribution. This information will be used to determine if projects are achieving goals and objectives and if statutory and regulatory requirements are being satisfied. States can be determined to be temporarily ineligible to participate in CACGP if an annual performance report is not provided, or if substantial progress is not being made in meeting the goals of the grant.

Performance Indicators for the CACGP:

The CACGP will be measured against the following performance measures:1) For States offering scholarship programs, the percentage increase in the proportion of

high school seniors offered CACGP grants who enroll in college within a year after graduation.

2) For the portion of State projects offering services directly to secondary schools, the percentage increase in the proportion of high school senior program participants who complete a Free Application for Federal Student Aid (FAFSA).

The CACGP will also be measured against the following efficiency measure:1) The decrease in the gap between the cost of the scholarship program per high school

senior offered a CACGP grant and the cost per high school senior offered a CACG scholarship and enrolling in college within a year after graduation.

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TITLE VIII—PARTNERSHIP GRANTSSEC. 801. COLLEGE ACCESS CHALLENGE GRANT PROGRAM.

Title VII (20 U.S.C. 1133 et seq.) is amended by adding at the end the following new part:

‘‘PART E—COLLEGE ACCESS CHALLENGE GRANT PROGRAM‘‘SEC. 771. COLLEGE ACCESS CHALLENGE GRANT PROGRAM.

(a) AUTHORIZATION AND APPROPRIATION.—There are authorized to be appropriated, and there are appropriated, to carry out this section $66,000,000 for each of the fiscal years 2008 and 2009. The authority to award grants under this section shall expire at the end of fiscal year 2009.

(b) PROGRAM AUTHORIZED.—

‘(1) GRANTS AUTHORIZED.—From amounts appropriated under subsection (a), the Secretary shall award grants, from allotments under subsection (c), to States (and to philanthropic organization, as appropriate under paragraph (3)) having applications approved under subsection (d), to enable the State (or philanthropic organization) to pay the Federal share of the costs of carrying out the activities and services described in subsection (f).

(2) FEDERAL SHARE; NON-FEDERAL SHARE.—

(A) FEDERAL SHARE.—The amount of the Federal share under this section fora fiscal year shall be equal to 2⁄3 of the costs of the activities and services described in subsection (f) that are carried out under the grant.

(B) NON-FEDERAL SHARE.—The amount of the non-Federal share under this section shall be equal to 1⁄3 of the costs of the activities and services described in subsection (f). The non-Federal share may be in cash or in-kind, and may be provided from State resources, contributions from private organizations, or both.

(3) REDUCTION FOR FAILURE TO PAY NON-FEDERAL SHARE.—If a State fails to provide the full non-Federal share required under this subsection, the Secretary shall reduce the amount of the grant payment under this section proportionately, and may award the proportionate reduction amount of the grant directly to a philanthropic organization, as defined in subsection (i), to carry out this section.

(4) TEMPORARY INELIGIBILITY FOR SUBSEQUENT PAYMENTS.—

(A) IN GENERAL.—The Secretary shall determine a grantee to be temporarily ineligible to receive a grant payment under this section for a fiscal year if—‘‘(i) the grantee fails to submit an annual report pursuant to subsection (h) for the preceding fiscal year; or

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(ii) the Secretary determines, based on information in such annual report, that the grantee is not effectively meeting the conditions described under subsection (g) and the goals of the application under subsection (d).

(B) REINSTATEMENT.—If the Secretary determines that a grantee is ineligible under subparagraph (A), the Secretary may enter into an agreement with the grantee setting forth the terms and conditions under which the grantee may regain eligibility to receive payments under this section.

(c) DETERMINATION OF ALLOTMENT.—

(1) AMOUNT OF ALLOTMENT.—Subject to paragraph (2), in making grant payments to grantees under this section, the allotment to each grantee for a fiscal year shall be equal to the sum of—

(A) the amount that bears the same relation to 50 percent of the amount appropriated under subsection (a) for such fiscal year as the number of residents in the State aged 5 through 17 who are living below the poverty line applicable to the resident’s family size (as determined under section 673(2) of the Community Service Block Grant Act) bears to the total number of such residents in all States; and

(B) the amount that bears the same relation to 50 percent of the amount appropriated under subsection (a) for such fiscal year as the number of residents in the State aged 15 through 44 who are living below the poverty line applicable to the individual’s family size (as determined under section 673(2) of the Community Service Block Grant Act) bears to the total number of such residents in all States.

(2) MINIMUM AMOUNT.—The allotment for each State under this section for a fiscal year shall not be an amount that is less than 0.5 percent of the total amount appropriated under subsection (a) for such fiscal year.

(d) SUBMISSION AND CONTENTS OF APPLICATION.—

(1) IN GENERAL.—For each fiscal year for which a grantee desires a grant paymentunder subsection (b), the State agency with jurisdiction over higher education, or another agency designated by the Governor or chief executive of the State to administer the program under this section, or a philanthropic organization, in accordance with subsection (b)(3), shall submit an application to the Secretary at such time, in such manner, and containing the information described in paragraph (2).

(2) APPLICATION.—An application submitted under paragraph (1) shall include the following:

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(A) A description of the grantee’s capacity to administer the grant under this section and report annually to the Secretary on the activities and services described in subsection (f).

(B) A description of the grantee’s plan for using the grant funds to meet the requirements of subsections (f) and (g), including plans for how the grantee will make special efforts to—

(i) provide such benefits to students in the State that are underrepresented in postsecondary education; or

(ii) in the case of a philanthropic organization that operates in more than one State, provide benefits to such students in each such State for which the H. R. 2669—31 philanthropic organization is receiving grant funds

under this section.

(C) A description of how the grantee will provide or coordinate the provision of the non-Federal share from State resources or private contributions.

(D) A description of—

(i) the structure that the grantee has in place to administer the activities and services described in subsection (f); or

(ii) the plan to develop such administrative capacity.

(e) SUBGRANTS TO NONPROFIT ORGANIZATIONS.—A State receiving a payment under this section may elect to make a subgrant to one or more nonprofit organizations in the State, including an eligible not-for-profit holder (as defined in section 435(p) of the Higher Education Act of 1965, as amended by section 303 of this Act), or those who have agreements with the Secretary under section 435(j), or a partnership of such organizations, to carry out activities or services described in subsection (f), if the nonprofit organization or partnership—

(1) was in existence on the day before the date of the enactment of this Act; and

(2) as of such day, was participating in activities and services related to increasing access to higher education, such as those activities and services described in subsection (f).

(f) ALLOWABLE USES.—

(1) IN GENERAL.—Subject to paragraph (3), a grantee may use a grant payment under this section only for the following activities and services, pursuant to the conditions under subsection (g):

(A) Information for students and families regarding—

(i) the benefits of a postsecondary education;

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(ii) postsecondary education opportunities;

(iii) planning for postsecondary education; and

(iv) career preparation.

(B) Information on financing options for postsecondary education and activitiesthat promote financial literacy and debt management among students and families.

(C) Outreach activities for students who may be at risk of not enrolling in or completing postsecondary education.

(D) Assistance in completion of the Free Application for Federal Student Aid or other common financial reporting form under section 483(a) of the Higher Education Act of 1965.

(E) Need-based grant aid for students.

(F) Professional development for guidance counselors at middle schools and secondary schools, and financial aid administrators and college admissions counselors at institutions of higher education, to improve such individuals’ capacity to assist students and parents with—

(i) understanding—

(I) entrance requirements for admission to institutions of higher education; and

(II) State eligibility requirements for Academic Competitiveness Grants or National SMART Grants under section 401A, and other financial H. R. 2669—32 assistance that is dependent upon a student’s coursework;

(ii) applying to institutions of higher education;

(iii) applying for Federal student financial assistance and other State, local, and private student financial assistance and scholarships;

(iv) activities that increase students’ ability to successfully complete the coursework required for a postsecondary degree, including activities such as tutoring or mentoring; and

(v) activities to improve secondary school students’ preparedness for postsecondary entrance examinations.

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(G) Student loan cancellation or repayment (as applicable), or interest rate reductions, for borrowers who are employed in a high-need geographical area or a high need profession in the State, as determined by the State.

(2) PROHIBITED USES.—Funds made available under this section shall not be used to promote any lender’s loans.

(3) USE OF FUNDS FOR ADMINISTRATIVE PURPOSES.—A grantee may use not more than 6 percent of the total amount of the sum of the Federal share provided under this section and the non-Federal share required under this section for administrative purposes relating to the grant under this section.

(g) SPECIAL CONDITIONS.—

(1) AVAILABILITY TO STUDENTS AND FAMILIES.—A grantee receiving a grant payment under this section shall—

(A) make the activities and services described in subparagraphs (A) through (F) of subsection (f)(1) that are funded under the payment available to all qualifying students and families in the State;

(B) allow students and families to participate in the activities and services without regard to—

(i) the postsecondary institution in which the student enrolls;

(ii) the type of student loan the student receives;

(iii) the servicer of such loan; or

(iv) the student’s academic performance;

(C) not charge any student or parent a fee or additional charge to participate in the activities or services; and

(D) in the case of an activity providing grant aid, not require a student to meet any condition other than eligibility for Federal financial assistance under title IV of the Higher Education Act of 1965, except as provided for in the loan cancellation or repayment or interest rate reductions described in subsection (f)(1)(G).

(2) PRIORITY.—A grantee receiving a grant payment under this section shall, in carrying out any activity or service described in subsection (f)(1) with the grant funds, prioritize students and families who are living below the poverty line applicable to the individual’s family size (as determined under section 673(2) of the Community Service Block Grant Act).

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(3) DISCLOSURES.—

(A) ORGANIZATIONAL DISCLOSURES.—In the case of a State that has chosen to make a payment to an eligible not-for-profit holder in the State in accordance with subsection (e), the holder shall clearly and prominently indicateH. R. 2669—33 the name of the holder and the nature of the holder’s work in connection with any of the activities carried out, or any information or services provided, with such funds.

(B) INFORMATIONAL DISCLOSURES.—Any information about financing options for higher education provided through an activity or service funded under this section shall—

(i) include information to students and the students’ parents of the availability of Federal, State, local, institutional, and other grants and loans for postsecondary education; and

(ii) present information on financial assistance for postsecondary education that is not provided under title IV of the Higher Education Act of 1965 in a manner that is clearly distinct from information onstudent financial assistance under such title.

(4) COORDINATION.—A grantee receiving a grant payment under this section shall attempt to coordinate the activities carried out with the grant payment with any existing activities that are similar to such activities, and with any other entities that support the existing activities in the State.

(h) REPORT.—A grantee receiving a payment under this section shall prepare and submit an annual report to the Secretary on the activities and services carried out under this section, and onthe implementation of such activities and services. The report shall include—

(1) each activity or service that was provided to students and families over the course of the year;

(2) the cost of providing each activity or service;

(3) the number, and percentage, if feasible and applicable, of students who received each activity or service; and

(4) the total contributions from private organizations included in the grantee’s non-Federal share for the fiscal year.

(i) DEFINITIONS.—In this section:

(1) PHILANTHROPIC ORGANIZATION.—The term ‘philanthropic organization’ means a non-profit organization—

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(A) that does not receive funds under title IV of the Higher Education Act of 1965 or under the Elementary and Secondary Education Act of 1965;

(B) that is not a local educational agency or an institution of higher education;

(C) that has a demonstrated record of dispersing grant aid to underserved populations to ensure access to, and participation in, higher education;

(D) that is affiliated with an eligible consortia (as defined in paragraph (2)) to carry out this section; and

(E) the primary purpose of which is to provide financial aid and support services to students from underrepresented populations to increase the number of such students who enter and remain in college.

(2) ELIGIBLE CONSORTIA.—The term ‘eligible consortia’ means a partnership of 2 or more entities that have agreed to work together to carry out this section that—

(A) includes—(i) a philanthropic organization, which serves as the manager of the consortia; H. R. 2669—34

(ii) a State that demonstrates a commitment to ensuring the creation of a Statewide system to address the issues of early intervention and financial support for eligible students to enter and remain in college; and

(iii) at the discretion of the philanthropic organization described in clause (i), additional partners, including other non-profit organizations, government entities (including local municipalities, school districts,cities, and counties), institutions of higher education, and other public or private programs that provide mentoring or outreach programs; and

(B) conducts activities to assist students with entering and remaining in college, which may include—

(i) providing need-based grants to students;

(ii) providing early notification to low-income students of their potential eligibility for Federal financial aid (which may include assisting students and families with filling out FAFSA forms), as well as other financialaid and other support available from the eligible consortia;

(iii) encouraging increased student participation in higher education through mentoring or outreach programs; and

(iv) conducting marketing and outreach efforts that are designed to—

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(I) encourage full participation of students in the activities of the consortia that carry out this section; and ‘‘(II) provide the communities impacted by the activities of the consortia with a general knowledge about the efforts of the consortia.

(3) GRANTEE.—The term ‘grantee’ means—

(A) a State awarded a grant under this section; or

(B) with respect to such a State that has failed to meet the non-Federal share requirement of subsection (b), a philanthropic organization awarded the proportionate reduction amount of such a grant under subsection (b)(3).

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INSTRUCTIONS FOR COMPLETING & SUBMITTINGTHE APPLICATION PACKAGE

I. Electronic Submission of Application

States must submit an application to the United States Department of Education to demonstrate eligibility and receive CACGP grant funding. All applications must be submitted electronically by e-mailing a Microsoft Word (.DOC) document to cacgp@ed.gov. We do not have a secure electronic signature mechanism, so applicants have two days after electronic submission to mail (postmarked) a signed title page and signed hard copies of the required assurances. The title page and assurances should be mailed and sent by facsimile transmission to the following address and phone number:

College Access Challenge Grant ProgramU.S. Department of EducationAttn: Karmon Simms-Coates1990 K Street, NW, Suite 6132Washington, D.C. 20006

FAX: (202) 502-7675

You may request permission to submit your application via mail 10 days prior to the application submission deadline by e-mailing karmon.simms-coates@ed.gov. In your request you must include the reason why you are unable to submit the application electronically.

Please note applications will not be accepted if the format/forms of the application have been altered or if the application is presented in a format other than Microsoft Word. II. Required Content of Application

1. Title Page 2. Section I : Abstract3. Section II: Project Narrative4. Section III: Goals and Objectives Form5. Section IV: Budget and Narrative Forms6. Section V: Governor’s Letter7. Section VI: Program Assurance Form8. Section VII: Standard Assurance Forms

1. Title Page. Applicants must provide a signed title page that contains necessary profile information.

a. Legal Name of Applicant. Enter the legal name of applicant and the name of the primary organization that will administer the grant.

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b. D-U-N-S Number. Enter applicant’s D-U-N-S Number. If your organization does not have a D-U-N- S Number, you can obtain the number by calling 1-800-333-0505 or by completing a D-U-N-S Number Request Form. The form can be obtained via the Internet at the following Web site: http://www.dnb.com.

c. Address. Enter the address of the Applicant Agency presented in box #1.

d. Contact Person. Enter the name, title, telephone and fax numbers, and email address of the person to be contacted on matters involving the application.

e. Type of Applicant. Please put a check by the type of organization that is applying.

f. Certification of Application Content and Assurances. Print name and telephone number; provide a signature from the authorizing representative of the organization; and date.

2. Section I: Abstract. Applicants must provide a one-page overview of the project that includes its goals, purpose and scope in the abstract section.

3. Section II: Project Narrative. Applicants must address in detail the questions listed inthe project narrative section.

4. Section III: Goals and Objectives Form. Applicants must submit the goals and objectivesfor the project. Activities, services and anticipated outcomes should be clearly aligned with the goals and objectives of the project. The goals provide the overall context for what the project is trying to accomplish in the long-term, and objectives describe what the project is trying to achieve incrementally.

5. Section IV: Budget Summary and Narrative Forms. The budget summary presents an outline of how funds will be used to accomplish the goals and objectives of the project. A complete summary of proposed expenditures (Federal and non-Federal) for each budget year must be provided. Each budget category must be justified in the budget narrative. For example, applicants should include: (1) the basis for estimating the costs of professional personnel salaries, benefits, project staff travel, materials and supplies, consultants and subcontracts, indirect costs, and any projected expenditures; (2) how the major cost items relate to the proposed activities; and (3) the costs of evaluation. States may use up to 6 percent of funds appropriated for administrative expenses.

6. Section V: Governor’s Letter. Applicants must submit a signed letter from theGovernor designating the agency that is responsible for administering the CACGP grant.

7. Section VI: Program Assurance Form. Applicants must respond with a yes or no answer to all assurances listed on the program assurance form.

8. Section VII: Standard Assurances -- Applicants must fill out and sign the following assurances required by the U.S. Department of Education.

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a. Disclosure of Lobbying Activities b. Certification Regarding Lobbying c. Non-Construction Programs

Application Format

Page Limit: You must limit the application (excluding the title page and program and standard assurances) to no more than 40 pages.

Please use the following formatting standards:

• Use 8.5” x 11” pages, on one side only, with 1” margins at the top, bottom, and both sides.• Double space (no more than three lines per vertical inch) all text in the application (excluding the title page and program and standard assurances).• Use one of the following fonts: Times New Roman or Arial.• Use a font that is either 12-point or larger or no smaller than10 pitch (characters per inch).• Use the version of Microsoft Word that ends in .DOC. If you are using Microsoft Word with the extension .DOCX or Microsoft Vista, you must convert it to .DOC before submission.

Contact Information

If you have questions regarding any aspect of this application, please contact:

Lynn Mahaffie, Director Teacher and Student Development Programs Service202-502-7903lynn.mahaffie@ed.gov

Karmon Simms-Coates, Program Manager College Access Challenge Grant Program 202-502-7807karmon.simms-coates@ed.gov

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OMB Control Number: 1840-001 Expiration Date: 05/31/2011

U.S. DEPARTMENT OF EDUCATIONCOLLEGE ACCESS CHALLENGE GRANT PROGRAM (CACGP)

TITLE PAGE

a. Legal Name of Applicant Agency b. D.U.N.S number:

Taxpayer ID Number (TN):

c. Address (include zip): d. Contact Person

Name:

Title:

Telephone:

Fax:

E-Mail:

e. Type of Applicant: ____ State Agency ____ Philanthropic Organization (non-profit) f. To the best of my knowledge and belief, all data provided in this application are true and correct. The governing body of the applicant has duly authorized the application and will comply with statutory and regulatory requirements, assurances and certifications, etc. Printed Name and Title of Authorized StateRepresentative:

Telephone:Fax:E-Mail:

Signature of Authorized State Representative: Date:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is ---. The time required to complete this information collection is estimated to average --- hours per response, including the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of the form, write directly to: the CACGP, U.S. Department of Education, 1990 K Street, N.W., Washington, D.C. 20006-8524.

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SECTION I: PROJECT ABSTRACT

Please provide a one-page abstract that gives an overview of the purpose, scope, and goals of the project.

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SECTION II: PROJECT NARRATIVE INFORMATION

Please answer thoroughly the following questions:

1. Please provide a description of the capacity and structure that the State has in place toadminister the authorized services and activities, or the State’s plan to develop such administrative capacity.

2. In the case of a philanthropic organization that operates in more than one State, please describe plans to use funding to benefit students in each State for which your organization is applying for grant funds.

3. Describe briefly the record keeping system for collecting and reporting student outcome/achievement data and participation in services and activities. Specifically, what method(s) will your project use to collect and maintain student and family participation in activities and outcome data?

4. If States plan to make sub-grants to non-profit organizations (partnership), describe the process for awarding and monitoring sub-grants to non-profit organizations (i.e., soliciting applications, application review process, timelines, selection criteria, technical assistance, site visits, progress reports, etc.).

5. Please list below the entities (State and local, philanthropic and other organizations) that will be actively involved in providing activities and services.

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SECTION III: GOALS AND OBJECTIVES FORM Please provide a detailed description of the activities and services that the State plans to provide using CACGP funding in order to address the needs of underrepresented students.

A. GOALS AND OBJECTIVES B. ACTIVITIES AND SERVICES C. PROPOSED OUTCOMES

Please provide measurable goals and objectives. List the activities and services that will be conducted to accomplish the goals and objectives.

List anticipated outcomes based on the implementation of services and activities.

Example: To increase underrepresented students’ and families’ knowledge of postsecondary education financial options.

Example: conduct informational workshops with parents and students to share sources and availability of financial aid; develop materials/handouts outlining financial aid opportunities.

Example: 2011 survey results (85% participation rate) indicate that 95% of participating students are more knowledgeable about financial aid opportunities.

1.

2.

3.

4.

5.

6.

SECTION IV: BUDGET SUMMARY FORM

Please provide a complete summary of proposed expenditures (Federal and non-Federal) for each budget year.

PROJECT YEAR 1 PROJECT YEAR 2Budget Categories FEDERAL NON-FEDERAL FEDERAL NON-FEDERAL TOTAL1. Salaries and Wages

2. Employee Benefits

3. Travel

4. Materials and Supplies

5. Consultants & Contracts6. OtherA. Total Direct Costs:

(Sum of lines 1-6)B. Total Indirect Costs:(cannot be greater than 8% of Total Direct Costs)C. Equipment D. Scholarships/Tuition AssistanceE. TOTAL REQUESTEDA + B+ C (Enter these figures in Item 7 of the Title Page)A grantee may use not more than 6 percent of the total amount of the sum of Federal funds and non-Federal funds for administrative purposes.

If you are requesting reimbursement for indirect costs on line B, please answer the following questions:(1) Do you have an Indirect Cost Rate Agreement approved by the Federal government? ____Yes ____ No If yes, please provide the following information: Period Covered by the Indirect Cost Rate Agreement: From: ___/___/______ To: ___/___/______ (mm/dd/yyyy) Approving Federal agency: ____ ED ____ Other (please specify): ____________ (2) For Restricted Rate Programs (check one) -- Are you using a restricted indirect cost rate

that: ___Is included in your approved Indirect Cost Rate Agreement? or ___ Complies with 34 CFR 76.564(c)(2)?

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BUDGET NARRATIVE

Please provide a justification for each budget category addressing Federal and non-Federal expenditures.

BUDGET CATEGORY FEDERAL EXPENDITURE NON-FEDERAL EXPENDITURE

1. Salaries and Wages

2. Employee Benefits

3. Travel

4. Materials and Supplies

5. Consultants & Contracts

6. Other

7. Equipment

8. Indirect Costs

9. Scholarship/Tuition Assistance

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SECTION V – GOVERNOR’S LETTER

Please include a signed letter from the Governor designating the agency that is responsible for administering the CACGP grant.

SECTION VI – PROGRAM ASSURANCES

The State makes the following assurances that it has policies and procedures in place as required by Title VII, Part E of Higher Education Act of 1965, as amended. Please put ‘yes’ (if assurance is given) or ‘no’ (if assurance cannot be given) next to the corresponding assurance. If you put ‘no’, please provide a date in the column for which the State will complete changes in order to provide assurance.

Yes No Assurances Related to Policies and Procedures1. States will give priority to students and families who are living below the poverty line applicable to students’ family size.

2. States must make activities and services available to all qualifying students and families regardless of a) choice of postsecondary institution; b) type of student loan received; c) server of such loan; and d) student’s academic performance.

3. States will include in any information about financing options for higher education provided through an activity or service:

a. the availability of federal, state, local institutional, and other grants and loans for postsecondary education; and

b. information on financial assistance for postsecondary education that is not provided under title IV of the Higher Education Act of 1965 in a manner that is clearly distinct from information on student financial assistance under such title.

4. States will ensure that sub-grantees have been in existence prior to September 27, 2007 and have experience in implementing activities and services related to increasing access to higher education.

5. The State will disclose when making a payment to an eligible not-for-profit holder in the State: the name of the holder and the nature of the holder’s work in connection with any of the activities carried out, or any information or services provided with funds.6. States will not use funds to promote any lender’s loans.

7. States will not use more than 6 percent of the total amount of the sum of Federal funds and non-Federal funds for administrative purposes.

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SECTION VII – STANDARD ASSURANCE FORMS

Please fill out the assurance forms presented in this section according to instructions. These forms must be signed and mailed, along with the title page, to the mailing address listed on Page 14 of this application.

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INSTRUCTIONS FOR COMPLETION OF SF-LLL,DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., “RFP-DE-90-001.”

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.

11. Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI).

12. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503

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Approved by OMB 0348-0046

DISCLOSURE OF LOBBYING ACTIVITIESComplete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352

(See reverse for public burden disclosure)

1. Type of Federal Action: a. contract ____ b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance

2. Status of Federal Action: a. bid/offer/application _____ b. initial award c. post-award

3. Report Type: a. initial filing _____ b. material change

For material change only:Year _______ quarter _______Date of last report___________

4. Name and Address of Reporting Entity: ____ Prime _____ Subawardee

Tier______, if known:

Congressional District, if known:

5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:

Congressional District, if known:

6. Federal Department/Agency: 7. Federal Program Name/Description:

CFDA Number, if applicable: __________________

8. Federal Action Number, if known: 9. Award Amount, if known:

$10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):

b. Individuals Performing Services (including address if different from No. 10a) (last name, first name, MI):

11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature: __________________________________

Print Name:_________________________________

Title:______________________________________

Telephone No.: ________________ Date: _______

Federal Use Only Authorized for Local ReproductionStandard Form - LLL (Rev. 7-97)

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CERTIFICATION REGARDING LOBBYING_____________________________________________________________________________________

Applicants must review the requirements for certification regarding lobbying included in the regulations cited below before completing this form. Applicants must sign this form to comply with the certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying." This certification is a material representation of fact upon which the Department of Education relies when it makes a grant or enters into a cooperative agreement._____________________________________________________________________________________

As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a Federal contract, grant or cooperative agreement over $100,000, as defined at 34 CFR Part 82, Sections 82.105 and 82.110, the applicant certifies that:

(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement;

(b) If any funds other than Federal appropriated funds have been paid or will be paid to any personfor influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions;

(c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants and contracts under grants and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certification.

NAME OF APPLICANT PR/AWARD NUMBER AND / OR PROJECT NAME

PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

SIGNATURE DATE

ED 80-0013

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OMB Approval No. 0348-0040

ASSURANCES - NON-CONSTRUCTION PROGRAMSPublic reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.

Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified.

As the duly authorized representative of the applicant I certify that the applicant:

1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management, and completion of the project described in this application.

2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.

3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain.

4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.

5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).

6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504

of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application.

7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or Federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases.

Previous Edition Usable Standard Form 424B (Rev. 7-97)Authorized for Local Reproduction Prescribed by OMB Circular A-102

29

8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.

9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for Federally assisted construction subagreements.

10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more.

11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).

12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system.

13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).

14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance.

15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.

16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.) which prohibits the use of lead- based paint in construction or rehabilitation of residence structures.

17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations.

18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program.

SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL

TITLE

APPLICANT ORGANIZATION DATE SUBMITTED

Standard Form 424B (Rev. 7-97) Back

Previous Edition Usable Standard Form 424B (Rev. 7-97)Authorized for Local Reproduction Prescribed by OMB Circular A-102

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